대사증후군과알라닌아미노전이효소와의관련성 : 국민건강영양조사제 3 기 (2005 년 )

원저 대사증후군과알라닌아미노전이효소와의관련성 : 국민건강영양조사제 3 기 (2005 년 ) 한미아류소연박종강명근김기순 조선대학교의과대학예방의학교실 조선대학교내성세포연구센터 서론 alcoholic steatohepatitis NASH) 2 2 [1] 2001 NCEP-ATP III Panel [2] (nonalcoholic fatty liver disease ) [3] [4] 1980 [5] (simple steatosis) (non- [6-8] 3-24%[9] 29% [10] 9-26% [11-12] 2 [3] NHANES III 2 2 [9] [13] [14] (alanine aminotransferase; ) NASH 90% [15] (aspartate aminotransferase; SGOT) 25

83% [16] [17] Hispanic Health and Nutrition Examination Survey 2999 20 (>43 IU/L) 41 [18] SGOT 40 IU/L 12-423 288-320 [11] 90 80 ) ( 130/85 mmhg ) ( 150 mg/dl) ( < 40 mg/dl < 50 mg/dl) ( 110 mg/dl ) 3 3 자료분석 SPSS ver 120 [22] 2005 (The Third Korea National Health and Nutrition Examination Survey; KNHANES 2005) 대상및방법 1 대상 2005 19 5278 HBsAg SGOT/ 2 SGOT 160 IU/L 40g 20g 953 4325 2 방법 40 IU/L NCEP/ATP III [2] - ( 19-44 45-64 65 p-value 005 연구성적 1 성에따른대사증후군과 증가와의관련성 279%(242 ) 266%(84 ) 137%(242 ) 33%(84 ) 90% 260% 20% 68% 26

Table 1 Association between the metabolic syndrome and the elevated alanine aminotransferase level by sex Metabolic syndrome Men(N=1764) Women(N=2561) Total Elevated Total Elevated No 1271(721) 114( 90) * 1880(734) 38(20) * Yes 493(279) 128(260) 681(266) 46(68) Abdominal obesity No 1291(732) 121( 94) * 1474(576) 20(14) * Yes 473(268) 121(256) 1087(424) 64(59) High blood pressure No 976(553) 106(109) * 1803(704) 45(25) * Yes 788(447) 136(173) 758(296) 39(51) High triglyceride No 1106(627) 79( 71) * 2009(784) 51(25) * Yes 658(373) 163(248) 552(216) 33(60) Low HDL-cholesterol No 926(525) 93(100) * 913(357) 22(24) * Yes 838(475) 149(178) 1648(643) 62(38) High blood glucose No 1508(855) 197(131) 2308(901) 64(28) * Yes 256(145) 45(176) 253( 99) 20(79) Values are expressed as frequency(%) * p<005 (Table 1) 460(95% CI=340-623) Table 2 Odds ratios for the elevated alanine aminotransferase level according to presence of the metabolic syndrome by sex (95% CI) Men(N=1764) (95% CI) (95% CI) Women(N=2561) (95% CI) Metabolic syndrome 355(269-470) 460(340-623) 351(226-544) 349(207-590) Abdominal obesity 332(251-439) 394(294-529) 454(273-756) 433(249-751) High blood pressure 171(130-225) 230(171-310) 211(136-328) 173(101-298) High triglyceride 428(320-571) 432(320-583) 244(155-382) 213(133-341) Low HDL-cholesterol 193(146-255) 195(147-259) 158(096-259) 145(088-240) High blood glucose 141(099-202) 188(128-276) 301(179-506) 239(136-418) OR odds ratio; CI confidence interval Adjusted for age(continuous variable) marital status(single with spouse widowed divorced separated) education status( elementary school middle school high school college) health insurance(community health insurance employer-provided health insurance medical aid uninsured) smoking(nonsmoker current smoker) and exercise(none regular) 27

(Table 2) 349(95% CI=207-590) 2 연령에따른대사증후군과 증가와의관련성 45-64 365% 65 496% 19-44 124% 19-44 80%(165 ) 45-64 80%(124 ) 65 52%(37 ) 19-44 55% 258% 45-64 44% 143% 65 28% 77% (Table 3) 19-44 457 (95% CI=313-667) 45-64 392(95% CI=264-582) Table 3 Association between the characteristics of the study population and the elevated alanine aminotransferase level by age Metabolic syndrome Age 19-44 years (N=2065) Age 45-64 years (N=1555) Age 65 years (N=705) Total Elevated Total Elevated Total Elevated No 1809(876) 99( 55) * 987(635) 43( 44) * 355(504) 10( 28) * Yes 256(124) 66(258) 568(365) 81(143) 350(496) 27( 77) Abdominal obesity No 1586(768) 83( 52) * 840(540) 42( 50) * 339(481) 16( 47) Yes 479(232) 82(171) 715(460) 82(115) 366(519) 21( 57) High blood pressure No 1746(846) 103( 59) * 822(529) 41( 50) * 211(299) 7( 33) Yes 319(154) 62(194) 733(471) 83(113) 494(701) 30( 61) High triglyceride No 1629(789) 65( 40) * 1007(648) 47( 47) * 479(679) 18( 38) * Yes 436(211) 100(229) 548(352) 77(141) 226(321) 19( 84) Low HDL-cholesterol No 967(468) 61( 63) * 619(398) 45( 73) 253(359) 9( 36) Yes 1098(532) 104( 95) 936(602) 79( 84) 452(641) 28( 62) High blood glucose No 1987(962) 153( 77) * 1291(830) 88( 68) * 538(763) 20( 37) * Yes 78( 38) 12(154) 264(170) 36(136) 167(237) 17(102) Values are expressed as frequency(%) * p<005 28

Table 4 Odds ratios for the elevated alanine aminotransferase level according to presence of the metabolic syndrome by age Age 19-44 years (N=2065) Age 45-64 years (N=1555) Age 65 years (N=705) (95% CI) (95% CI) (95% CI) (95% CI) (95% CI) (95% CI) Metabolic syndrome 600(424-847) 457(313-667) 365(248-537) 392(264-582) 288(137-605) 343(159-742) Abdominal obesity 374(270-517) 516(358-744) 246(167-362) 369(244-558) 122(063-239) 146(071-302) High blood pressure 384(273-541) 203(141-292) 243(165-358) 216(145-322) 188(081-436) 192(081-451) High triglyceride 716(512-999) 460(320-661) 333(228-487) 298(202-440) 235(120-457) 239(121-470) Low HDL-cholesterol 155(111-215) 214(151-304) 117(080-172) 142(096-211) 179(083-385) 223(099-502) High blood glucose 217(115-412) 151(076-300) 215(142-326) 185(121-283) 293(150-574) 279(141-552) OR odds ratio; CI confidence interval Adjusted for age(continuous variable) marital status(single with spouse widowed divorced separated) education status( elementary school middle school high school college) health insurance(community health insurance employer-provided health insurance medical aid uninsured) smoking(nonsmoker current smoker) and exercise(none regular) (95% CI=159-742) 65 (Table 4) 343 고찰 [21] Mallory ( ) [19] [20] [12] [23] ( ) [24] [91725-27] HBsAg SGOT/ 2 SGOT 160 IU/L 29

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Metabolic Syndrome and Serum Alanine Aminotransferase Levels in Korean Adults : The Third Korea National Health and Nutrition Examination Survey (KNHANES ) 2005 Mi Ah Han 1)2) So Yeon Ryu 1)2) Jong Park 1)2) Myung Geun Kang 1) Ki Soon Kim 1) Purpose: The aim of this study was to investigate the association between the metabolic syndrome and alanine aminotransferase() levels in Korean adults Methods: The study subjects were 4325 adults aged 19 years without an apparent cause of liver disease from the Third Korea National Health and Nutrition Examination Survey(2005) The metabolic syndrome was defined using criteria established by the NCEP/ATP III while abdominal obesity was assessed based on the Asia-Pacific guidelines Subjects with 40 IU/L were considered to have elevated levels Demographic characteristics waist circumference blood pressure triglyceride HDL cholesterol fasting blood sugar were recorded for statistical analysis Results: The prevalence of elevated levels was significantly increase with the presence of the metabolic syndrome and its components In multiple logistic regression analyses odds ratio for the elevated levels was significantly high in the subjects with the metabolic syndrome compared to the subjects without metabolic syndrome after adjusted for socio-demographic characteristics and health-related behavior Conclusions: The metabolic syndrome was independently associated with levels in Korean adults : Metabolic Syndrome X Alanine Aminotransferase() 33